I was on a video conferencing coffee session with a few global thought leaders on the impact of the Covid-19 Pandemic on African economies, when I was asked an interesting question. How will Africa, especially countries like Nigeria respond to the next Pandemic? Initially, I stuttered before proceeding with my oft-used line revolving around social distancing, wearing a face mask, frequent hand washing and the standard globally recommended practices. As I regurgitated these measures, I also began to question the effectuality of these steps on the long-term impact of the incidence and spread of the Covid-19 virus.
For many that know me, I seem to have found many versions of myself. I started my career first as a dentist, then a board-certified maxillofacial surgeon with experiences in Central America, North America, Europe and Africa and now, I am an energy-enthusiast in Nigeria.
When Covid-19 spread into Nigeria, I found myself volunteering via a professional energy group, to support initiatives for dealing with the crisis in the country. From this experience, I discovered that a lot of my scientific knowledge about decision making and human behaviour during health crisis were not practical in Nigeria. This is primarily because best practices are usually contextual to the environment in which you make recommendations.
While the key intent of this write-up is not necessarily didactic, it is important that we take the lessons from the impact of pandemics on global population and economy, while we all do our best to prevent them. The 1918 H1N1 pandemic, also known as the Spanish Flu, was estimated to have infected over 500 Million people and killed between 50- 100 million people. Later, research by Alice Reid PhD, revealed that besides the death toll and paralysis of global economies, children who were conceived during that pandemic grew up to have lower incomes, poorer educational outcomes and higher rates of physical disability. There has also been significant documentation in medical literature, on the effect on the cardiovascular system.
Globally, concern about pandemics has become so high that after the last global Ebola outbreak in 2014-2015, the 44th president of the United States of America, President Barack Obama, assembled a strong health team in 2016, that came up with the guidelines “Playbook for Early Response to High-Consequence Emerging Infectious Disease Threats and Biological Incidents.” Interestingly, in 2019, global health leaders supported by The Johns Hopkins Centre for Health Security, World Economic Forum, and Bill & Melinda Gates Foundation, jointly supported a Health Pandemic prevention sessions/scenario for implementation globally. The exercise was best practice.
Needless to say, when the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, using many vectors of spread, caused the Coronavirus disease 2019 (COVID-19), almost every country questioned, doubted, challenged and rebuffed the strategy to management, as the world went from a first wave to an initial second wave and currently, to a questionable second wave with mutation and different permutations.
Full disclosure: I am not an epidemiologist or a health expert. In fact, I haven’t treated a patient professionally, in close to a decade. However, the solutions needed to protect us do not need to be created anew. They also have to be contextual for Africa, especially Nigeria.
I regard Nigeria as a microcosm of Africa and have therefore chosen to use the Nigerian illustration to project the rest of Africa. Of course, this does not mean the scenarios or experiences are the same across Africa, but owing to some similarities in our governance, cultural beliefs and per capita income, the outcomes may turn out to be similar.
When the first case of Covid-19 hit Nigeria on February 27, 2020, the anxious feeling that we might have been left out of the global pandemic seemed to have finally abated. Aside from the Nigerian Centre for Disease Control (NCDC), virtually every elected official, government parastatal and “non- medical” professional became an expert. It was particularly interesting how the NCDC leadership became “resource professionals” while non- pandemic experts attempted to dictate the approach to preventing the spread and fatality associated with Covid-19. I would easily place myself in the box of “non-medical” professional. Although, I was always clear that our role was to “support the NCDC” in its objectives.
So, after the Federal Government has officially spent about 36 Billion Naira (as of August 2020) and the private- unorganized private sector estimated to have spent just as much on health measures and palliatives, we seem to be back to where we were at the onset of the pandemic. A friend recently said to me humorously, that if the virus were a person, it would have been picked up by the Economic and Financial Crimes Commission (EFCC) to account for the impact of expending such a huge amount on the Covid-19 intervention in Nigeria.
Due to the general state of healthcare infrastructure, I was always of the opinion that Nigeria’s best efforts should have been focused on prevention of spread. Do everything to prevent the spread of the virus, test and isolate as soon as possible and invest the rest of the funds in rehabilitating and building sustainable health care infrastructure, including testing laboratories.
Having shared my perspective, there was no guarantee that we would not be in the same situation even if the national health leaders had followed my advice to the letter. In my opinion, this is because we are a unique breed. From initial assertions that covid-19 was not a virus that could afflict Africans to beliefs about its attenuation by high temperature and added to these misguided positions, our addiction for social events, we seemed to be a dream shop for the Virus. Fortunately, what I suspect to be elements of innate resistance or immunity have significantly upset the virus’ plans for Nigeria.
However, the economic impact has been devastating.
The impact of the economic slowdown on demand for crude oil and the lack of storage in Nigeria, basically led to our literally paying people to take our crude oil. Almost every industry, except the telecom and banking industry (I bet they will refute this) was negatively impacted. Recovery from this economic setback may not happen for at least two economic cycles, if we were to implement the best policies. Nigeria seems to be more impacted because global demand for the single commodity that generates the most revenue for the country is reducing due to an anticipated increase in demand for non-fossil fuel. The combination of these two sets us up for a negative recovery if the right steps are not taken towards preventing the next pandemic.
What are the right next steps? The truth is I don’t know and I am not sure anyone does. However, there are a few things that I believe would help. Firstly, we need an updated national census focused on demographics to help identify and pinpoint crucial areas for attention.
Secondly, prevention has to be led from a grassroots level. We need to be able to use our primary health care in identifying and managing cases. The failure of the primary health care system led to an attempt to centrally manage the outbreak of Covid-19. A mistake, in my view.
Thirdly, we need to invest in our health care facilities using appropriate data tracking technology and software. The number of Nigerians who are building covid-19 tracking and isolation applications reveal a potential that should be invested in.
Lastly, we should pay serious attention to research and development. It is ironic to see the number of Nigerians playing leading roles in vaccine development on the global stage, yet we find ourselves queuing up and at the mercy of other countries, hoping to secure vaccine allocations.
If we take these aforelisted advisory steps on spread prevention, by the time the next pandemic emerges, we will not only ensure that there is ease of identification and disease tracking, nationwide presence of health care facilities that are equipped and competent in managing pandemics, and we should also be well placed to vaccinate our population against the pandemic.
Speculations are already afoot that the next pandemic is likely to originate from a yeast-like fungus that closely resembles that of the black plague. This “perfect pathogen” could be Candida Auris. If it enters the blood stream, the results will be fatal.
It may not be a question of “if”, but “when” this pandemic emerges.
Will we be ready?
Dr Ogundare is the CEO of Newcross Petroleum
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